肽疗法在肌肉骨骼医学中的应用 资料

本页面由机器翻译,尚未经临床医生审核。英文版本为权威版本。

您的感受

您可能正经历软组织疼痛和僵硬。这种不适感可能深在肌肉内或沿肌腱分布。通常在白天活动后症状会加重。您可能注意到晨起时症状最为明显。活动后僵硬感可能略有缓解,但若过度用力,症状可能会再次出现。

简单的日常任务可能变得困难。您可能难以将手伸到背后扣上文胸。整理衬衫时可能会牵拉疼痛区域。患侧卧位睡眠可能导致失眠。这些细微动作可能引发锐痛或持续存在的钝痛。您的主刀医生了解这些限制如何影响您的日常生活。

尽管某些治疗方法在动物研究中显示出前景,但目前缺乏关于注射肽疗法在人类中应用的证据。尚无随机对照试验调查 BPC-157 在人体受试者中的使用情况。目前的科学证据尚不足以确定其在运动表现增强方面的整体有效性和安全性。因此,您的主刀医生不建议使用 BPC-157 来提升运动表现和促进恢复。

部分患者通过其他方法获得缓解。例如,EGYFIL 已被证明在治疗软组织疼痛和僵硬方面是安全的。它似乎能在治疗期间的三天内减轻疼痛和僵硬。您可能在首次应用后三小时即感到缓解。然而,结果因人而异,您的主刀医生将帮助您选择最安全的后续治疗方案。

倾听身体的声音非常重要。如果某项活动引起锐痛,请停止并休息。按照医疗团队的指导应用冰敷或热敷。记录疼痛最严重的时间。这有助于您的主刀医生量身定制您的治疗方案。请记住,愈合需要时间。对您的康复进展保持耐心,并与您的医疗团队就您的感受保持开放沟通。

实际发生了什么

您的身体依靠一种微妙的平衡来保持关节的顺畅活动。软骨作为骨骼末端的平滑涂层,而肌腱则像强韧的绳索,将肌肉连接到骨骼。当您损伤这些结构时,自然的修复过程往往不足。例如,当肌腱撕裂时,肌腱与骨骼之间的连接可能无法以所需的强度或结构愈合。这会导致不稳定和疼痛,因为锚定点受到了损害。

在某些情况下,关节表面本身会磨损或出现缺陷。这可能发生在受伤后,或者由于长期压力所致。平滑的表面变得粗糙,导致您在活动时产生摩擦和不适。您的身体试图通过将细胞发送到该区域来修复这些问题,但有时修复组织薄弱,或与周围的健康组织整合不佳。这就是为什么简单的休息或基本治疗可能无法完全解决问题的原因。

研究人员正在探索支持这一愈合过程的新方法。一些方法使用特殊的肽——蛋白质的微小构建模块——来鼓励您的身体更有效地进行自我修复。在动物研究中,某些肽在加强肌腱-骨连接和改善软骨愈合方面显示出前景。其他治疗方法旨在快速减少炎症,帮助您在几小时或几天内减轻疼痛和僵硬。然而,重要的是要知道,对于许多这些较新的疗法,如 BPC-157,目前尚无来自人体试验的临床证据来证明它们对运动恢复有效或安全。您的外科医生可以帮助您了解哪些选项有坚实的支持,哪些仍处于实验阶段。

预期情况

您应了解,目前尚无证据支持在骨科和运动医学中常规使用多种注射用肽类疗法。对于大多数此类治疗,科学依据仍然不足。这意味着我们尚无法确认其整体疗效、安全性或促进愈合的最佳使用方式。

某些特定肽类在早期实验室研究中显示出前景,但这些结果来自大鼠、马或细胞培养,而非人体。例如,某些肽类在大鼠模型中有助于肌腱愈合,在马模型中有助于软骨修复。然而,BPC-157 尚无人体试验。由于缺乏人体数据,我们不推荐将 BPC-157 用于运动表现或恢复。科学证据尚不足以支持其在运动员中的使用。

存在少数已有相关人体数据的例外情况。EGYFIL 便是其中之一。该疗法在减轻软组织疼痛和僵硬方面似乎安全。您可能在首次应用后三小时内即注意到症状减轻。治疗疗程通常持续三天,在此期间您应感到疼痛和僵硬减轻。

对于其他情况,如滑车缺损(一种关节面损伤),与不进行治疗相比,自组装肽类或微骨折等治疗可改善症状。然而,这种改善源于不同方法所导致的不同机制。

总体而言,您的预后取决于具体疗法。许多肽类治疗缺乏经证实的人体益处。其他疗法(如 EGYFIL)可提供短期的疼痛和僵硬缓解。您的外科医生将帮助您了解哪些选项具有真实证据支持,哪些没有。我们旨在建立现实的期望,而非做出承诺。如果某项治疗缺乏强有力的人体数据,我们将如实告知您。


Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • Orthopaedic and sports medicine providers must understand the current lack of evidence to support the clinical use of injectable peptide therapies, despite their potential therapeutic and regenerative benefits [1].
  • Therapeutic strategies for microfracture augmentation, such as those using growth factor–functionalized self-assembling peptide hydrogel scaffolds, can be cost-effective ways to improve cartilage healing outcomes [2].
  • Functionalized self-assembled peptides with hBMP7 biological activity promote the differentiation of adipose-derived stem cells (ADSCs) into nucleus pulposus-like cells [3].
  • Treatment of trochlear defects with only KLD (self-assembling peptide) or only microfracture resulted in an improvement in clinical symptoms compared with no treatment [4].
  • The improvement in clinical symptoms from treating defects with only KLD or only microfracture likely resulted from different causes depending on the treatment [4].
  • The literature on injuries involving artificial turf is suitable for qualitative analysis only due to vast heterogeneity in factors such as level of play, sex, and definition of injury [5].
  • The authors do not recommend the use of BPC-157 for sports performance and recovery because there are no randomized controlled trials investigating its use in human subjects [7].
  • The science is clearly lacking to determine the overall effectiveness, safety profile, and clinical indications for BPC-157 use in sports enhancement in athletes [7].
  • The critical reader uses figures in publications to guide the interpretation of study findings that are described in the text [8].
  • EGYFIL, a topical lotion based on hyaluronic acid and peptides, is safe and seems to reduce pain and stiffness in patients during the 3 days of treatment [9].
  • EGYFIL reduces pain and stiffness in patients already after 3 hours from the first application [9].

How It Works

  • Injectable peptide therapy possesses significant therapeutic and regenerative potential [1].
  • Orthopaedic and sports medicine providers currently lack sufficient evidence to support the clinical use of peptide therapies [1].
  • Self-assembling peptides with hBMP7 biological activity promote the differentiation of adipose-derived stem cells (ADSCs) into nucleus pulposus-like cells [3].
  • Treatment of trochlear defects with only KLD self-assembling peptide or only microfracture results in an improvement in clinical symptoms compared with no treatment [4].
  • The improvement in clinical symptoms from KLD or microfracture treatment likely results from different causes depending on the specific treatment [4].
  • There are no randomized controlled trials investigating the use of BPC-157 in human subjects [7].
  • The science is lacking to determine the overall effectiveness, safety profile, and clinical indications for BPC-157 use in sports enhancement in athletes [7].
  • The authors do not recommend the use of BPC-157 for sports performance and recovery [7].
  • EGYFIL, a topical lotion based on hyaluronic acid and peptides, is safe for the treatment of pain and stiffness in soft tissues [9].
  • EGYFIL reduces pain and stiffness in patients during a 3-day treatment period [9].
  • EGYFIL reduces pain and stiffness already after 3 hours from the first application [9].
  • BMP-7 application significantly enhances the quality of tendon-to-bone healing by promoting structural maturation [10].
  • BMP-7 application significantly enhances the quality of tendon-to-bone healing by promoting functional stability [10].
  • GHRP-2 administration reduced M1 macrophage polarization in a rat rotator cuff tear model [11].
  • GHRP-2 administration enhanced histologic tendon-bone healing properties in a rat rotator cuff tear model [11].
  • GHRP-2 administration enhanced biomechanical tendon-bone healing properties in a rat rotator cuff tear model [11].
  • Axon preservation and minimal inflammation were observed in animals treated with BDNF-incorporated biofunctionalized peptide-based hydrogel [12].
  • Locomotor functional recovery was not observed in animals treated with BDNF-incorporated biofunctionalized peptide-based hydrogel [12].
  • The designed intervention of BDNF-incorporated hydrogel indicates potentiality for further evaluations in developing efficient therapies for severe spinal cord injury [12].

What the Evidence Shows

  • Orthopaedic and sports medicine providers must understand the current lack of evidence to support the clinical use of injectable peptide therapies [1].
  • The improvement in clinical symptoms from KLD or microfracture alone likely resulted from different causes depending on the treatment [4].
  • Injectable therapeutic peptides are not recommended for sports performance and recovery because there are no randomized controlled trials investigating their use in human subjects [7].
  • The science is lacking to determine the overall effectiveness, safety profile, and clinical indications for peptide use in sports enhancement in athletes [7].
  • BMP-7 application significantly enhances the quality of tendon-to-bone healing by promoting structural maturation and functional stability in a rat rotator cuff tear model [10].
  • GHRP-2 administration enhanced histologic and biomechanical tendon-bone healing properties in a rat rotator cuff tear model [11].

Practical Considerations

  • The science is lacking to determine the overall effectiveness, safety profile, and clinical indications for BPC-157 in sports enhancement in athletes [7].
  • The use of BPC-157 for sports performance and recovery is not recommended [7].
  • Functionalized self-assembled peptides promote the differentiation of adipose-derived stem cells (ADSCs) into nucleus pulposus-like cells [3].
  • Treatment of trochlear defects with only KLD (self-assembling peptide) resulted in an improvement in clinical symptoms compared with no treatment [4].
  • Treatment of trochlear defects with only microfracture resulted in an improvement in clinical symptoms compared with no treatment [4].
  • The improvement in clinical symptoms from KLD or microfracture treatment likely resulted from different causes depending on the treatment [4].
  • EGYFIL reduces pain and stiffness in patients during the 3 days of treatment [9].

Key Evidence

  • [L5] While peptide therapy may possess significant therapeutic and regenerative potential, it is critical that orthopaedic and sports medicine providers understand the current lack of evidence to support the clinical use of these peptides. [1] (10.1177/03635465251357593)
  • [L5] Therapeutic strategies for microfracture augmentation, such as those presented in this study, can be cost-effective ways to improve cartilage healing outcomes. [2] (10.1177/03635465211021798)
  • [L5] The functionalized self-assembled peptide promotes the differentiation of ADSCs into nucleus pulposus-like cells. [3] (10.1186/s13018-022-03102-8)
  • [L5] Treatment of defects with only KLD or with only microfracture resulted in an improvement in clinical symptoms compared with no treatment; the improvement likely resulted from different causes depending on the treatment. [4] (10.2106/jbjs.m.01408)
  • [L4] The authors argue that the literature on injuries involving artificial turf is suitable for qualitative analysis only due to vast heterogeneity in factors such as level of play, sex, and definition of injury. [5] (10.1177/03635465231210186)
  • [L5] The authors do not recommend the use of BPC-157 for sports performance and recovery because there are no randomized controlled trials investigating its use in human subjects, and the science is clearly lacking to determine the overall effectiveness, safety profile, and clinical indications for sports enhancement in athletes. [7] (10.1016/j.arthro.2024.09.005)
  • [L5] The critical reader uses figures in publications to guide the interpretation of study findings that are described in the text. [8] (10.1177/03635465241259467)
  • [L4] EGYFIL is safe and seems to reduce pain and stiffness in patients during the 3 days of treatment, already after 3 h from the first application. [9] (10.1186/s12891-023-06903-y)
  • [L5] BMP-7 application significantly enhances the quality of tendon-to-bone healing by promoting structural maturation and functional stability. [10] (10.1016/j.jse.2026.04.003)
  • [L5] GHRP-2 administration reduced M1 macrophage polarization and enhanced histologic and biomechanical tendon-bone healing properties in a rat rotator cuff tear model. [11] (10.1016/j.arthro.2024.11.094)
  • [L5] Although locomotor functional recovery was not observed, axon preservation and minimal inflammation in animals treated with BDNF-incorporated hydrogel indicate the potentiality of the designed intervention for further evaluations in the path of developing efficient therapies for severe spinal cord injury. [12] (10.1016/j.injury.2018.12.027)

References

[1] Injectable Peptide Therapy: A Primer for Orthopaedic and Sports Medicine Physicians. The American Journal of Sports Medicine. 2026. DOI: 10.1177/03635465251357593

[2] Microfracture Augmentation With Trypsin Pretreatment and Growth Factor–Functionalized Self-assembling Peptide Hydrogel Scaffold in an Equine Model. The American Journal of Sports Medicine. 2021. DOI: 10.1177/03635465211021798

[3] Self-assembling peptides with hBMP7 biological activity promote the differentiation of ADSCs into nucleus pulposus-like cells. Journal of Orthopaedic Surgery and Research. 2022. DOI: 10.1186/s13018-022-03102-8

[4] Effects of the Combination of Microfracture and Self-Assembling Peptide Filling on the Repair of a Clinically Relevant Trochlear Defect in an Equine Model. Journal of Bone and Joint Surgery. 2014. DOI: 10.2106/jbjs.m.01408

[5] Lower Extremity Injury Rates on Artificial Turf Versus Natural Grass Playing Surfaces: Response. The American Journal of Sports Medicine. 2024. DOI: 10.1177/03635465231210186

[7] Injectable Therapeutic Peptides—An Adjunct to Regenerative Medicine and Sports Performance?. Arthroscopy. 2024. DOI: 10.1016/j.arthro.2024.09.005

[8] The Critical Reader: Visualizing Data. The American Journal of Sports Medicine. 2024. DOI: 10.1177/03635465241259467

[9] A pre-market interventional, single-arm clinical investigation of a new topical lotion based on hyaluronic acid and peptides, EGYFILTM, for the treatment of pain and stiffness in soft tissues. BMC Musculoskeletal Disorders. 2023. DOI: 10.1186/s12891-023-06903-y

[10] Effects of BMP-7 and Low Molecular Weight Peptide Solution on Healing in a Rotator Cuff Tear Model: A Histopathological and Biomechanical Study in Rats. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2026.04.003

[11] Growth Hormone–Releasing Peptide 2 May Be Associated With Decreased M1 Macrophage Production and Increased Histologic and Biomechanical Tendon‐Bone Healing Properties in a Rat Rotator Cuff Tear Model. Arthroscopy. 2024. DOI: 10.1016/j.arthro.2024.11.094

[12] Biofunctionalized peptide-based hydrogel as an injectable scaffold for BDNF delivery can improve regeneration after spinal cord injury. Injury. 2019. DOI: 10.1016/j.injury.2018.12.027